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Mazzucchi A. Cognitive evaluation and rehabilitation in high- and low-income countries. J Neuropsychol 2024; 18:1-14. [PMID: 37424164 DOI: 10.1111/jnp.12338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 06/22/2023] [Accepted: 06/22/2023] [Indexed: 07/11/2023]
Abstract
Starting from her own personal experience, in the First Part of the article, the author reconstructs how the specialized sectors of cognitive evaluation and rehabilitation evolved in Western countries (Europe, the United States, Canada, and Australia, in particular) during the second half of the last century and the first decades of this century. In the Second Part, she describes her personal experience in setting up a rehabilitation centre dedicated to traumatic brain-injured subjects and her commitment to international cooperation (Bolivia, Rwanda, Myanmar, Tanzania) in the field of cognitive evaluation and rehabilitation in favour of people with congenital and acquired cerebral pathology, especially in the paediatric age, since there is an almost total lack of diagnostic, but above all, rehabilitative procedures for cognitive functions in low-middle income countries. In the Third Part of the article, the author carries out an extensive review of the international literature on the differences in access to cognitive diagnostic evaluation and cognitive rehabilitation in middle- and low-income countries - but not only - underlining the urgent need to launch a major international collaborative effort to reduce and eliminate these discrepancies.
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Affiliation(s)
- Anna Mazzucchi
- Former Teacher of Neuropsychology and Neurological Rehabilitation, University of Parma, Parma PR, Italy
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Basagni B, Martelli S, Mazzucchi A, Cecchi F. Amnesia of Uncertain Etiology in an Adolescent during COVID-19 Pandemic: A Case Report. Case Rep Neurol 2022; 14:223-230. [PMID: 35702447 PMCID: PMC9149488 DOI: 10.1159/000523733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 01/23/2022] [Indexed: 11/19/2022] Open
Abstract
Sudden retrograde memory loss, in the absence of neurological causes, is usually referred to as a dissociative symptom. Dissociative amnesia, defined in the DSM-V as an inability to remember important autobiographical experiences, usually of a traumatic or stressful nature, is however a controversial phenomenon. Few cases with this pattern are described in the scientific literature and still fewer regarding adolescents. The objective of this study was to describe the case of an unexplained sudden memory loss that only partially fits with the criteria for dissociative amnesia, in a juvenile patient aged 16 years, which occurred during the COVID-19 lockdown. After the exclusion of any organic disturbances, 10 days after the clinical onset, a series of psychometric (neuropsychological and psychodiagnostics) tests were administered to the patient. Recent distress associated with COVID-19 lockdown was reported, while no previous significant distress or psychiatric history emerged during the clinical interview, conducted with the patient and parents. Severe disturbances in remote memory tests were registered, while no impairments in cognitive or anterograde amnestic functions were found or personality disorders. The disturbance was diagnosed as “amnesia of uncertain etiology.”
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Affiliation(s)
- Benedetta Basagni
- IRCCS Fondazione Don Carlo Gnocchi-ONLUS, Florence, Italy
- *Benedetta Basagni,
| | | | - Anna Mazzucchi
- IRCCS Fondazione Don Carlo Gnocchi-ONLUS, Florence, Italy
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi-ONLUS, Florence, Italy
- Department of Clinical and Experimental Medicine, University of Florence, Florence, Italy
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Basagni B, Martelli S, Ruffini L, Mazzucchi A, Cecchi F. Progressive Unspecified Motor Speech Disorder: A Longitudinal Single Case Study of an Older Subject. Geriatrics (Basel) 2022; 7:52. [PMID: 35645275 PMCID: PMC9149977 DOI: 10.3390/geriatrics7030052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 04/13/2022] [Accepted: 04/19/2022] [Indexed: 01/27/2023] Open
Abstract
INTRODUCTION In a few cases, neurodegenerative diseases debut with a speech disorder whose differential diagnosis can be difficult. CASE REPORT We describe the case of a right-handed woman with a progressive speech impairment, which debuted when she was 80 years old. We report the results of neurological, neuropsychological, and imaging assessments with positron emission tomography (PET) over a period of nine years. Metabolic PET with 18F-FDG was performed at the age of 81 and repeated two years later due to the worsening of symptoms; amyloid PET with 18F-flutemetamol was performed at the age of 86. All PET results were quantitatively analyzed. A speech impairment remained the isolated neurological symptom for a long time, together with a mood disorder. Early FDG-PET showed hypometabolism in the left superior and inferior frontal areas, in the left superior temporal area, and in the right superior frontal area. Two years later, the hypometabolic area was more extensive. Amyloid PET was qualitatively and quantitatively normal. Nine years after the first symptoms, the speech production progressively worsened until complete anarthria, in association with writing impairment onset and signs of behavioral impairments. No signs of motor involvement were found. CONCLUSIONS A progressive articulatory disorder without an evolution of motor disorders may be a distinct neurological degenerative entity, mainly affecting speech production for very a long time and with a specific early metabolic pattern in brain FDG-PET in the language production area. Monitoring patients with FDG-PET could predict the disease evolution years before a clinical deterioration.
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Affiliation(s)
- Benedetta Basagni
- IRCCS Fondazione Don Carlo Gnocchi-ONLUS, Via di Scandicci, 269, 50143 Florence, Italy; (A.M.); (F.C.)
| | - Sonia Martelli
- IDIPSI, Istituto di Psicoterapia Sistemica Integrata, Strada Vallazza, 6, 43100 Parma, Italy;
| | - Livia Ruffini
- Nuclear Medicine Division, Azienda Ospedaliero-Universitaria di Parma, 43126 Parma, Italy;
| | - Anna Mazzucchi
- IRCCS Fondazione Don Carlo Gnocchi-ONLUS, Via di Scandicci, 269, 50143 Florence, Italy; (A.M.); (F.C.)
| | - Francesca Cecchi
- IRCCS Fondazione Don Carlo Gnocchi-ONLUS, Via di Scandicci, 269, 50143 Florence, Italy; (A.M.); (F.C.)
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Arcuri F, Cortese MD, Riganello F, Lucca LF, Serra S, Mazzucchi A, Cerasa A, Tonin P. The Reliability of the Progression of Autonomies Scale Applied on Acquired Brain Injured Patients. Front Neurol 2019; 10:342. [PMID: 31024435 PMCID: PMC6469362 DOI: 10.3389/fneur.2019.00342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/20/2019] [Indexed: 11/13/2022] Open
Abstract
The Progression of Autonomies Scale (PAS) is a behavioral scale useful to assess the autonomy levels in acquired brain-injured patients. It provides a broad profile, assessing different domains of human activities ranging from personal, domestic, and extradomestic autonomies. This cross-sectional study is aimed at evaluating the reliability of this scale on a large cohort of acquired brain injury (ABI) patients. Fifty-one ABI patients (49% traumatic, 33.3% hemorrhagic, 17.7% other etiologies), hospitalized in the S. Anna Institute of Crotone, Italy (mean age male 46.08 ± 14.53 and mean age female patients 43.2 ± 11.3) were recruited. We found a high level of reliability of the scale, with a coefficient at the inter-rater agreement between substantial (0.61 ≤ k ≤ 0.8) and almost perfect (0.81 ≤ k ≤ 1), and almost perfect at the test-retest (intra-rater). We confirm that the PAS is a well-structured tool for the assessment of the autonomy levels in brain-injured patients. These findings encourage the application of this scale in the clinical practice of rehabilitation unit to design a tailored rehabilitation treatment on real goals and to monitor the generalization of the recovered abilities to the daily routine activities.
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Affiliation(s)
- Francesco Arcuri
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy
| | | | | | | | - Sebastiano Serra
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy
| | - Anna Mazzucchi
- Department for ABI Care and Rehabilitation, Don Gnocchi Foundation, Milan, Italy
| | - Antonio Cerasa
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy.,Neuroimaging Unit, IBFM-CNR, Catanzaro, Italy
| | - Paolo Tonin
- Research in Advanced Neurorehabilitation, S. Anna Institute, Crotone, Italy
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Devalle G, Castiglioni P, Arienti C, Abbate C, Mazzucchi A, Agnello L, Merati G. Cardio-respiratory autonomic responses to nociceptive stimuli in patients with disorders of consciousness. PLoS One 2018; 13:e0201921. [PMID: 30208114 PMCID: PMC6135369 DOI: 10.1371/journal.pone.0201921] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 07/24/2018] [Indexed: 12/26/2022] Open
Abstract
The autonomic response to pain might discriminate among consciousness disorders. Therefore, aim of this study was to describe differences between minimally conscious state (MCS) and unresponsive wakefulness syndrome (UWS) patients in their autonomic response to a nociceptive stimulus. ECG, respiration, finger blood pressure (BP) and total peripheral resistances (TPR) were continuously recorded before, during and after a standardized noxious stimulus in 20 adult brain-injured patients, 14 in UWS and 6 in MCS. Occurrence of fast autonomic responses synchronous with the stimulus was detected by visual inspection of the tracings; short-term (<20 s) and long-term (between 20s and 50 s from the stimulus) responses were evaluated by beat-by-beat quantitative analysis. The noxious stimulus elicited fast responses in both groups, but only MCS patients showed a significant short-term response in TPR and long-term response in HR. Thus, short- and long-term cardiovascular responses to pain might integrate neuro-behavioural assessments to discriminate between MCS and UWS.
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Affiliation(s)
- Guya Devalle
- Vegetative State Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | | | - Chiara Arienti
- Vegetative State Unit, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
| | - Carlo Abbate
- Geriatric Unit, Fondazione IRCCS Ca’ Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - Anna Mazzucchi
- Rete Gravi Cerebrolesioni Acquisite, IRCCS Fondazione Don Carlo Gnocchi, Santa Maria dei Servi, Parma, Italy
| | - Luca Agnello
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
| | - Giampiero Merati
- Department of Biomedical Sciences for Health, University of Milan, Milan, Italy
- Center of Sports Medicine, IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy
- * E-mail:
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Redolfi A, Gugliotta M, Borsotti M, D'Amato A, Gemignani P, Maietti A, Mezzanato T, Sapienza S, Trimarchi PD, Negrini S, Mazzucchi A. Long-term services for the care and rehabilitation of people with severe acquired brain injury: a multicentre, cross-sectional study of 536 Italian families. Ann Ist Super Sanita 2017; 53:253-265. [PMID: 28956806 DOI: 10.4415/ann_17_03_12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND People with severe acquired brain injuries (ABIs) require complex, long-term multidisciplinary healthcare, and social welfare programmes, and their families experience social and emotional consequences that profoundly condition their quality of life. OBJECTIVE To investigate whether the possibility of gaining access to local rehabilitation and other services positively influences not only the quality of life of the patients but also the quality of life of their families. METHODS The sample consisted of 536 families of patients with severe ABIs. They were administered a specific 50-item questionnaire with a mix of multiple choice answers, dichotomous (yes/no) answers, or answers based on a Likert-type scale. RESULTS The results suggest that the long-term services provided to patients are substantially satisfactory but the data concerning the patients' social and working reintegration are discomforting. Furthermore, the families experience profound social discomfort related to their economic, emotional and caregiving burden regardless of the number and quality of the rehabilitation services activated, or the amount of welfare support received. CONCLUSIONS Post-severe ABI services provided at a local level should include not only long-term rehabilitative and social support for the patients, but also long-term social and psychological support for their families.
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Affiliation(s)
| | - Maria Gugliotta
- Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Parma, Parma, Italy
| | | | | | | | | | - Tiziana Mezzanato
- IRCCS Santa Maria Nascente, Fondazione Don Gnocchi Onlus, Milan, Italy
| | - Sabrina Sapienza
- IRCCS Santa Maria Nascente, Fondazione Don Gnocchi Onlus, Milan, Italy
| | | | - Stefano Negrini
- IRCCS Santa Maria Nascente, Fondazione Don Gnocchi Onlus, Milan, Italy - Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Brescia, Brescia, Italy
| | - Anna Mazzucchi
- IRCCS Santa Maria Nascente, Fondazione Don Gnocchi Onlus, Milan, Italy
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Redolfi A, Bartolini G, Gugliotta M, Maietti A, Pietrapiana P, Sapienza S, D'Amato A, Mazzucchi A. When a parent suffers ABI: Investigation of emotional distress in children. Brain Inj 2017; 31:1050-1060. [PMID: 28481652 DOI: 10.1080/02699052.2017.1297486] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PRIMARY OBJECTIVE To investigate the type of emotional and behavioural impact that having a parent with a severe acquired brain injury (ABI) has on children during the first period of adjustment. METHODS AND PROCEDURE The study involved 25 couples in which one of the spouses was affected by ABI, and their 35 children (3-14 years). The children attended three sessions with a psychologist aimed at identifying their spontaneous playing and relational behaviour by means of a grid created on the basis of ICD-10 criteria. Both members of each parental couple attended a session with the psychologist, and were administered the Dyadic Adjustment Scale, the 36-item Health Survey and the Caregiver Burden Inventory. RESULTS 63% of the children showed signs of emotional suffering, the presence of which was underestimated by their parents on the basis of the psychologist's assessments. The variables that correlated most closely with the children's psychological condition were related to the quality of their parents' relationship. CONCLUSIONS Our findings confirm the need for early interventions aimed at both parents and their children in order to investigate the children's emotional-affective situation, and favour an understanding of their discomfort by their parents.
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Affiliation(s)
- A Redolfi
- a IRCCS Santa Maria Nascente, Fondazione Don Gnocchi , Milan , Italy
| | | | - M Gugliotta
- c Department of Clinical & Experimental Medicine , University of Parma , Parma , Italy
| | - A Maietti
- a IRCCS Santa Maria Nascente, Fondazione Don Gnocchi , Milan , Italy
| | - P Pietrapiana
- a IRCCS Santa Maria Nascente, Fondazione Don Gnocchi , Milan , Italy
| | - S Sapienza
- a IRCCS Santa Maria Nascente, Fondazione Don Gnocchi , Milan , Italy
| | - A D'Amato
- d IRCCS Don Carlo Gnocchi, Fondazione Don Gnocchi , Firenze , Italy
| | - A Mazzucchi
- a IRCCS Santa Maria Nascente, Fondazione Don Gnocchi , Milan , Italy
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Sguazza E, Mazzucchi A, Fortunati M, Cattaneo C. The necropolis of Bolgare (Lombardy, Italy): Anthropological and paleopathological features of a Lombard population. Homo 2015; 66:139-48. [PMID: 25703806 DOI: 10.1016/j.jchb.2014.09.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2014] [Accepted: 09/03/2014] [Indexed: 11/25/2022]
Abstract
The mediaeval necropolis of Bolgare - St. Chierico is an important site in northern Italy, located in the Bergamo Province (about 40 km East of Milan). In order to reconstruct aspects of the demographic and health status of this Lombard population, macroscopic (morphological, metric and radiographic) and microscopic analyses were performed on over 400 skeletons for the assessments of sex (cranial and pelvic morphology, metrics), age (subadults: dental and bone development; adults: mainly pubic symphysis, auricular surface of the ilium, 4th rib) and stature, for the determination of ancestry and the identification of pathologies. Results proved the sample to be heterogeneous with males, females, adults and subadults. The sample seemed to be composed of several groups, including individuals with northern or eastern (Uralic) European features and, on the other hand, individuals with central European or Mediterranean characteristics. The first may be indicative of migrations of Lombards (suggested by tall stature estimates); the second could be considered autochthonous, bearing features more typical of northern Italian populations. Among palaeopathological finds, the study showed the presence of tuberculosis, gout, DISH and degenerative pathologies particularly on the pelvis and spinal column. The population of Bolgare constitutes one of the main sources of anthropological data on Lombards in Italy.
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Affiliation(s)
- E Sguazza
- LABANOF - Laboratorio di Antropologia e Odontologia Forense, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy; Dipartimento di Biotecnologie e Scienze della Vita, Università degli Studi dell'Insubria, Varese, Italy
| | - A Mazzucchi
- LABANOF - Laboratorio di Antropologia e Odontologia Forense, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy
| | - M Fortunati
- Soprintendenza per i Beni Archeologici della Lombardia, Milano, Italy
| | - C Cattaneo
- LABANOF - Laboratorio di Antropologia e Odontologia Forense, Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Milano, Italy.
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Abbate C, Trimarchi PD, Basile I, Mazzucchi A, Devalle G. Sensory stimulation for patients with disorders of consciousness: from stimulation to rehabilitation. Front Hum Neurosci 2014; 8:616. [PMID: 25157226 PMCID: PMC4127462 DOI: 10.3389/fnhum.2014.00616] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2014] [Accepted: 07/23/2014] [Indexed: 11/05/2022] Open
Affiliation(s)
- Carlo Abbate
- Unità Operativa Complessa di Geriatria, Fondazione I.R.C.C.S. Ca' Granda, Ospedale Maggiore Policlinico Milan, Italy
| | - Pietro D Trimarchi
- Nucleo di Accoglienza per Persone in Stato Vegetativo, Fondazione I.R.C.C.S. Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Isabella Basile
- Nucleo di Accoglienza per Persone in Stato Vegetativo, Fondazione I.R.C.C.S. Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Anna Mazzucchi
- Nucleo di Accoglienza per Persone in Stato Vegetativo, Fondazione I.R.C.C.S. Don Carlo Gnocchi ONLUS, Milan, Italy
| | - Guya Devalle
- Nucleo di Accoglienza per Persone in Stato Vegetativo, Fondazione I.R.C.C.S. Don Carlo Gnocchi ONLUS, Milan, Italy
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Abstract
This chapter reviews the changes produced by age on various aspects of artistic painting, particularly creativity and actual production. Aging in trained painters is often accompanied by a decline in creativity, which in turn is due to the cognitive decline related to aging. It has been argued, however, that aging does not cause a decline, but only changes in style and content. The two views are not mutually exclusive, and we present examples illustrating both aspects. We also show that, in addition to cognitive changes, impairment of sensory organs, especially vision, and of the bones and joints, may also produce marked changes in an artist's production and style. We conclude by showing that finding ways to induce creativity in persons who do not consider themselves artists can be a way of stimulating creativity and contribute to successful aging.
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Zampolini M, Corea F, Avesani R, Boldrini P, De Tanti A, Di Stefano MG, Formisano R, Lamberti G, Lombardi F, Mazzucchi A, Pistarini C, Taricco M, Citterio A. Rehabilitation of acquired brain injuries: a multicentric prospective survey. Eur J Phys Rehabil Med 2013; 49:365-372. [PMID: 23389644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND The rehabilitation of the persons with Severe Acquired Brain Injury (ABI) is an important concern to be approached with a comprehensive program aimed to improve the recovery of patients.The efficacy of an early and intensive rehabilitation program has been shown in large number of studies. Few studies focused on the prevalence of TBI and the data are often extrapolated in indirect ways. AIM An analysis of the demographic characteristics of the population included in the GISCAR (Gruppo Italiano per lo Studio delle Gravi Cerebrolesioni Acquisite e Riabilitazione- Italian Group for the Study of the severe ABI) database, type and conditions associated to the index event; the treatment administered during hospitalization; and the prognosis according to outcome measures. DESIGN The study was an observational prospective survey looking at management of ABI (both traumatic and non-traumatic). SETTING In hospital rehabilitation. POPULATION Patients consecutively admitted in each of the 52 GISCAR centres. METHODS Every centre included a consecutive cohort and recorded demographic data and index event characteristics. RESULTS In the study population were included 2626 subjects suffering of a severe ABI. The difference of length of stay (LOS) was significantly different with 67.5 days for traumatic patients compared to the 80 days of non traumatic ones. In the study population the probability of discharge at home is significantly greater for the traumatic condition (odds ratio 0,4587; CI 0.3671-0.5731). The overall benefit of the rehabilitative treatment was encountered in a net gain in all disability scores taken into account: LCF classes; DRS as well as GOS scores. At discharge the main destination for severe ABI patients was home (67.2%). CONCLUSIONS A large number of patients admitted in Italian rehabilitative facilities for a severe ABI suffered from a TBI, more often these subjects were young male victims of road accident. The majority of subjects during the rehabilitative hospitalization demonstrated a significant recovery. CLINICAL REHABILITATION IMPACT Considering the evidence of an early treatment benefit the delay ofthe rehabilitation program start is far from being satisfactory. The high frequency of the home discharge indicate a good compliance of national family network.
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Affiliation(s)
- M Zampolini
- Operative Unit of Severe Acquired Brain Lesions, Asl 3 Umbria, Foligno, Perugia, Italy -
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Abstract
Focal lesions such as strokes significantly affect painting production in the vast majority of artists. In particular, painters, when they resume painting, show changes in their painting style. In exceptional cases, there may be an apparent improvement in style, but in most cases, the changes represent nothing short of deterioration. This, however, varies according to the hemisphere affected. Painters with left-hemisphere lesions tend to show an inability to deal adequately with perspective and also tend to use simplified colors with fewer nuances. One often witnesses an evolution toward simpler, often "naïve" techniques, and at times rigid geometric repetitive features. Painters with right-hemisphere lesions also become unable to represent tridimensionality. In addition, their figures are often drawn in very summary fashion, with lack of coordination between volumes and space and a chromatic impoverishment; their main problem, however, is visuospatial, leading to neglect of the left side of the canvas.
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Arcuri F, Lucca LF, Rosadini V, Mercurio G, Mazzucchi A. Evaluation of autonomies in the severely brain injured: the Progression of Autonomies Scale. Funct Neurol 2013; 28:29-38. [PMID: 23731913 PMCID: PMC3812722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The aim of this study was to validate the Progression of Autonomies Scale (PAS) for the evaluation of autonomies in severe acquired brain injury patients. The PAS design is based on a model of progressive recovery of autonomies and is organized in three domains (Personal, Domestic and Extra-domestic). Scores assigned range from zero to three. The PAS items gather information about the patient's perception and awareness of his/her disability(ies) on admission and perception of his/her improvement at the end of a rehabilitation process. The PAS was administered to 127 inpatients on admission to and at discharge from a rehabilitation program. All 127 inpatients, recruited in a prospective multicenter study, completed the rehabilitation program. The statistical analysis identified a total of 38 items to be retained in the PAS, out of an initial 82 items. The results provide evidence of the validity and reliability of the PAS in its final version.
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Affiliation(s)
- Francesco Arcuri
- Research in Advanced Neurorehabilitation, S.Anna Institute, Crotone, Italy.
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Busetto M, Giordani L, Brandone A, Cattaneo C, Mazzucchi A. Dietary investigation by trace element content in bones of ancient inhabitants of Northern Italy. J Radioanal Nucl Chem 2007. [DOI: 10.1007/s10967-007-7070-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Pattoneri P, Tirabassi G, Pelá G, Astorri E, Mazzucchi A, Borghetti A. Circadian Blood Pressure and Heart Rate Changes in Patients in a Persistent Vegetative State After Traumatic Brain Injury. J Clin Hypertens (Greenwich) 2007; 7:734-9. [PMID: 16330896 PMCID: PMC8109359 DOI: 10.1111/j.1524-6175.2005.04780.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Alteration of autonomic nervous system regulation is known to be present in the persistent vegetative state after traumatic brain injury, termed the dysautonomic syndrome. This study assessed the circadian blood pressure and heart rate pattern and variability in the persistent vegetative state through noninvasive 24-hour ambulatory blood pressure monitoring. The study was performed in 20 subjects: 10 patients (six men and four women; mean age, 29.5+/-9.9 years; range, 19-39 years) in a vegetative state (mean, 27.3+/-5.6 days after trauma) and 10 healthy subjects as controls (six men and four women; mean age, 28+/-5.7 years; range, 29-37 years). The patients showed a blood pressure nondipper pattern; 24-hour, daytime, and nighttime values of blood pressure and heart rate were significantly higher in patients than in controls. The day-night difference in heart rate and blood pressure was also significantly lower in patients. Finally, SD and variation coefficients were significantly lower in patients. The results show changes in the variability and circadian blood pressure and heart rate patterns in persistent vegetative state patients with dysautonomic syndrome, as an expression of the sympathetic-parasympathetic activity imbalance in the control of vasomotor tone.
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Affiliation(s)
- Paolo Pattoneri
- Department of Internal Medicine, Nephrology and Health Sciences, University of Parma, Parma, Italy.
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Boller F, Sinforiani E, Mazzucchi A. Preserved painting abilities after a stroke. The case of Paul-Elie Gernez. Funct Neurol 2005; 20:151-5. [PMID: 16483452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
In a famous paper published in 1948, the French neurologist Théophile Alajouanine discussed the influence of aphasia on artistic output. He used as examples three artists he had personally examined. They were the musician Maurice Ravel, the writer Valery Larbaud, and a painter whose name was not mentioned. We have now discovered the identity of this painter and therefore present, for the first time, with the permission of his family, an analysis of the works of Paul-Elie Gernez (1888-1948) before and after his cerebral stroke. This painter's ability to produce works of art was not really diminished by his aphasia. However, we do believe that there was a change in his style, which seemed to become less poetic, as though his ability to "invent" had decreased and he had lost some of his spontaneity. This and other published cases strongly suggest that in some artists the effect of cerebral lesions is different from that found in individuals with no artistic training. This difference may be attributable to the presence, in the former, of an expanded cortical representation, secondary to their lifelong formal training.
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Casanova E, Lazzari RE, Lotta S, Mazzucchi A. Locked-in syndrome: improvement in the prognosis after an early intensive multidisciplinary rehabilitation. Arch Phys Med Rehabil 2003; 84:862-7. [PMID: 12808539 DOI: 10.1016/s0003-9993(03)00008-x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To evaluate prognosis and recovery in patients with locked-in syndrome (LIS) receiving early intensive rehabilitative care. DESIGN Consecutive sample and follow-up for 5 months to 6 years. SETTING Three rehabilitation centers in Italy. PARTICIPANTS Fourteen patients with LIS who underwent the same treatment and subsequently recovered. INTERVENTIONS Intensive nursing care and intensive and early rehabilitative program, including physiotherapy and respiratory, swallowing, and speech training. For 4 patients, occupational therapy was performed; 4 subjects also had oculomotor training. After discharge, rehabilitative maintenance care continued for each patient. MAIN OUTCOME MEASURES Motor recovery according to the Patterson and Grabois classification, functional improvement, and mortality rate. RESULTS A significant motor recovery was found in 21% of subjects, within 3 to 6 months of onset of the morbid event; complete swallow recovery in 42%; verbal communication in 28%; communication through devices in 42%; effective bladder and bowel control in 35%; and good breathing patterns in 50%. At follow-up, the mortality rate was 14% and only 2 complications were reported. CONCLUSIONS Intensive and early rehabilitation, begun within about 1 month of the morbid event, improved the functional recovery and reduced the mortality rate, which, as reported in the literature, had been 60% about 10 years ago. Further studies are necessary to confirm these data.
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Cattelani R, Tanzi F, Lombardi F, Mazzucchi A. Competitive re-employment after severe traumatic brain injury: clinical, cognitive and behavioural predictive variables. Brain Inj 2002; 16:51-64. [PMID: 11796099 DOI: 10.1080/02699050110088821] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PRIMARY OBJECTIVE To contribute to the identification of relationships between the return to pre-trauma competitive activities at the final discharge from rehabilitation facilities, and neuroanatomical, neuropsychological and behavioural data collected at different phases of the recovery from a traumatic brain injury (TBI). METHODS AND PROCEDURES Thirty-five severe TBI subjects were retrospectively selected from 228 consecutive admissions over a 3-year period, according to pre-morbid, clinical and demographic characteristics matching the established selection criteria, and submitted to comprehensive neurophysiological, intellectual, cognitive and behavioural examinations carried out at different stages of the recovery (acute, subacute and chronic phases). EXPERIMENTAL INTERVENTIONS Barthel Activity of Daily Living (BADL) index, Wechsler Adult Intelligence Scale-Revised (WAIS-R), checklists aimed to detect cognitive and behavioural dysfunction. MAIN OUTCOMES AND RESULTS TBI subjects successfully re-employed obtained significantly better scores on length of coma and PTA, intellectual status, cognitive functioning and behavioural competence. Other specific measures of injury severity (CT-scan abnormalities, GCS score level, BADL index) resulted as being unrelated to the resumption of pre-trauma competitive activities. CONCLUSIONS Findings seem to confirm the opinion that a significant relationship exists between the initial TBI severity level, especially as indicated by the duration of coma and PTA, and eventual return to work at the final discharge from facilities.
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Mazzucchi A, Mammi P, Viappiana I. [Rehabilitative strategies in patients with subarachnoid hemorrhage]. Minerva Anestesiol 1998; 64:251-4. [PMID: 9773671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
The role of rehabilitative treatment in neurological disorders due to subarachnoid haemorrhage is described in acute, intermediate and chronic phases. A fourth phase, defined phase of diagnosis and treatment of cognitive and behavioural "cripto-deficits", is discussed. In each phase, emphasis is put on the organization of rehabilitative work which should always be the result of integrative team approach, to prevent and correct complications and to apply an holistic treatment (physical and cognitive). At present, in neurological rehabilitation, the most important requirement is no longer have the professionals (physiotherapists, speech and occupational therapists, etc.), but have a suitable environment and a good organisation of team planning and work. Neurosurgical centers is warranted. Practice guidelines should be addressed to obtain quality and continuity of management in the early diagnostic phase; intensive global medical approach should be ensured by neuroanesthesists and intensivists to achieve optimal cerebral conditions before surgical or endovascular treatment.
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Affiliation(s)
- A Mazzucchi
- Servizio di Neuroriabilitazione, Università degli Studi, Parma
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Abstract
In order to obtain indicative data regarding intellectual, behavioural and social outcome into adulthood of subjects with a history of childhood head injury (CHI), twenty adults were selected who had been referred to the Neuropsychology Unit at the University of Parma at the time of a traumatic brain injury (TBI) at an age between 8 and 14 years. The level of intellectual and behavioural impairment was determined and rated by WISC and WAIS IQa and by the frequency of maladjustive behaviour. GOS score and Barthel index were used to detect the level of disability. Social adjustment and community integration were determined by the Social Adjustment Scale (SAS) and the Community Integration Questionnaire (CIQ) respectively. Results indicate that (1) subjects who suffer a severe CHI present a higher pre-injury incidence of character disturbances than the normal population and injury-related difficulties to socialize which persist long-term and add to other problems; (2) even though intellectual and functional sequelae are frequent in these children in adulthood and do not improve in their correlation to age, these do not appear to be the prevailing problems and (3) the prevailing problems seem to be social maladjustment and poor quality of life, which are still present several years post-injury and seem to be related to behavioural and psychosocial disorders in spite of an increased ADL-functioning. This has already been clearly demonstrated in the case of adulthood trauma.
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Affiliation(s)
- R Cattelani
- Department of Neurology, University of Parma, Italy
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21
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Pavesi G, Brianti R, Medici D, Mammi P, Mazzucchi A, Mancia D. Botulinum toxin type A in the treatment of upper limb spasticity among patients with traumatic brain injury. J Neurol Neurosurg Psychiatry 1998; 64:419-20. [PMID: 9527178 PMCID: PMC2170006 DOI: 10.1136/jnnp.64.3.419] [Citation(s) in RCA: 22] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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22
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Cattelani R, Gugliotta M, Maravita A, Mazzucchi A. Post-concussive syndrome: paraclinical signs, subjective symptoms, cognitive functions and MMPI profiles. Brain Inj 1996; 10:187-95. [PMID: 8777390 DOI: 10.1080/026990596124502] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
In order to investigate the organic and psychogenic components of post-concussive syndrome (PCS), the subjective complaints, the cognitive findings and the Minnesota Multiphasic Personality Inventory (MMPI) profiles of 53 consecutive mild head injury patients (MHI) with persistent PCS were evaluated. The results seem to suggest the presence of two groups: in the first, minimal lesional signs were associated with more prolonged loss of consciousness (LC) and post-traumatic amnesia (PTA), as well as an MMPI profile not indicative of a neurotic state, whereas in the second the absence of any lesional sign was associated with shorter LC and PTA duration, as well as evidence of neurotic MMPI scores. A female prevalence was observed in the first group and a male prevalence in the other one.
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Affiliation(s)
- R Cattelani
- Department of Neurology, University of Parma, Italy
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23
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Abstract
The classic amnesic syndrome is characterised by a severe anterograde amnesia and a less important retrograde amnesia with sparing of the semantic component. We report the case of a patient who showed a global amnesic syndrome following a mild head injury. Initially, amnesia was both anterograde and retrograde, and also involved semantic knowledge. Two years later the picture had changed remarkably. The retrograde deficit for autobiographical events was still total, while semantic memory had recovered to a large extent. Learning had also greatly improved, but only if assessed after a short delay; abnormally rapid forgetting rate were found at longer intervals. This pattern of impairment does not lend itself to an easy interpretation. However, the hypothesis of a consolidation deficit may be advanced.
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Affiliation(s)
- A Maravita
- Clinica Neurologica, University of Parma
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24
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Abstract
We report two brothers affected by a dominantly inherited form of hereditary sensory and autonomic neuropathy (HSAN), characterized by clinical features of sensory ataxia, and by late onset in the 6th decade. Sural nerve biopsy in the proband showed almost complete loss of myelinated fibers, and relative sparing of unmyelinated fibers. This family showed an atypical presentation of HSAN, which is usually characterized by acrodystrophic manifestations of infantile or juvenile onset. Although a few reports of HSAN presenting with late onset and/or ataxia appeared, this is the first report of a family with dominant HSAN characterized by late onset sensory ataxia.
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Affiliation(s)
- A Marbini
- Institute of Neurology, University of Parma, Italy
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25
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Mazzucchi A, Sinforiani E, Ludovico L, Turla M, Pacchetti C, Brianti R, Parma M, Nappi G. Reaction time responses in parkinsonian and hemiparkinsonian patients. Mov Disord 1993; 8:13-8. [PMID: 8419803 DOI: 10.1002/mds.870080103] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Twenty-one normal subjects, 32 bilateral parkinsonian patients (BPs) and 29 hemiparkinsonian patients (HP) were submitted to separate or sequentially associated motor tasks that included simple reaction times (RT), choice RTs, directional RTs, and movement RTs. The results showed that simple RTs, directional RTs, and movement times (MT) were slower in BPs as compared to normal subjects; for choice RTs there was no difference. Response patterns were similar in normal controls and BPs. In both groups RTs became more prolonged as sequentially programmed operations increased. If movement occurred at the end of the sequence, they prolonged the RTs of the preceding operations, but MTs per se did not vary. In HPs the same results were observed on the "bad" hand side versus normal controls and versus the healthy side, but a significant statistical level was reached mainly when the "bad" hand was the right one.
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Affiliation(s)
- A Mazzucchi
- Department of Neurology, University of Parma, Italy
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26
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Mazzucchi A, Cattelani R, Missale G, Gugliotta M, Brianti R, Parma M. Head-injured subjects aged over 50 years: correlations between variables of trauma and neuropsychological follow-up. J Neurol 1992; 239:256-60. [PMID: 1607886 DOI: 10.1007/bf00810347] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Neuropsychological follow-up was studied in 70 consecutive head-injured subjects aged over 50 years. Diffuse deterioration (28%), moderate deterioration (25%) and dementia (21%) were the most frequent sequelae. Analysis of correlations between neuropsychological sequelae and trauma variables showed that: (1) mild trauma did not necessarily imply good prognosis and could be followed by very severe consequences; (2) duration of post-traumatic amnesia was correlated with coma duration but not with neuropsychological outcome; (3) on the whole, no prognostic predictor of the outcome was found.
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Affiliation(s)
- A Mazzucchi
- Department of Neurology, University of Parma, Italy
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27
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Abstract
A patient who developed a unilateral opercular syndrome following a cerebrovascular accident is described. Computed tomography showed that the lesion did not affect the opercular cortex, but involved deep white matter and the head of the caudate nucleus of the left hemisphere. Persistent hypophonia and transient aphasia were associated. Comparison with previous cases is discussed.
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Affiliation(s)
- L Posteraro
- Sezione di Neuropsicologia, Università di Parma, Italy
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28
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Sinforiani E, Zinelli P, Faglia L, Granella F, Mauri M, Manzoni GC, Turla M, Mazzucchi A. Lateralization of visual attention in patients with classic migraine and unilateral prodromes. Funct Neurol 1989; 4:247-52. [PMID: 2792859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
The present study is aimed to investigate whether and how mechanisms of visual attention are changed into conditions of monohemispheric disorders. For this purpose, Posner's paradygm was applied to classic migraine patients with prodromal phenomena localized in one hemisphere. The subjects were examined in acute phase (within 24 h of the episode end) and after a week or more from the episode (interparoxysmal phase). The patients in interparoxysmal phase behaved as normal subjects. In acute phase, we observed a selective involvement of attentional behaviour in migraineurs with left hemispheric symptoms. A possible explanation might be based on the well-known tendency of this hemisphere to prevail in performing attentive tasks.
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Affiliation(s)
- E Sinforiani
- Department of Neurology, University of Pavia, Italy
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29
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Mazzucchi A. Neuropsychological rehabilitation. Neuropsychologia 1989. [DOI: 10.1016/0028-3932(89)90065-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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30
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Mazzucchi A, Sinforiani E, Zinelli P, Agostinis C, Granella F, Miari A, Manzoni GC, Parma M. Interhemispheric attentional functioning in classic migraine subjects during paroxysmal and interparoxysmal phases. Headache 1988; 28:488-93. [PMID: 3243711 DOI: 10.1111/j.1526-4610.1988.hed2807488.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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31
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Abstract
A family lineage is reported in whom several subjects, all of them females, suffered from SDAT. The existence of a subgroup of inherited dementias affecting only females is discussed.
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32
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Mazzucchi A. Transient global amnesia: definition and clinical phenomenology. Ital J Neurol Sci 1988; Suppl 9:11-6. [PMID: 3049443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Based on personal observations and analysis of the most impressive literature, some considerations are made on transient global amnesia definition and clinical phenomenology.
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Affiliation(s)
- A Mazzucchi
- Sezione di Neuropsicologia, Clinica Neurologica, Università di Parma
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Mazzucchi A, Capitani E, Poletti A, Posteraro L, Bocelli G, Campari F, Parma M. Discriminant analysis of WAIS results in different types of dementia and depressed patients. Funct Neurol 1987; 2:155-63. [PMID: 3666544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
A Multivariate Analysis of Covariance and Discriminant Analysis were carried out on complete WAIS profiles obtained from three groups of demented patients: Multi-Infarct Dementia patients, Senile Dementia of Alzheimer Type patients, and Alcoholic Dementia patients. A group of middle-aged Depressed patients was also included. WAIS did not differentiate among dementias, but Picture Completion and Block Design subtests proved to be effective in differentiating dementia from depression.
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Affiliation(s)
- A Mazzucchi
- Department of Neurology, University of Parma, Italy
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34
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Abstract
Involuntary groping-grasping responses to visual stimuli were studied in relation to the location of the stimuli in the space surrounding the patient. The following space-related patterns of stimulus-response were observed in four patients: (a) responses were evoked only by visual stimuli in the hemispace ipsilateral to the arm involved; (b) responses were evoked only by visual stimuli within the reach of maximal arm extension; (c) responses were evoked only by visual stimuli in the space around the hand; (d) all such patterns were variously combined. These findings are discussed in relation to the general problem of specific correlations between sensorimotor subsystems and peripersonal behavioral space.
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Affiliation(s)
- G Magnani
- Istituto di Clinica Neurologica, Università di Parma, Italia
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35
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Sinforiani E, Farina S, Mancuso A, Manzoni GC, Bono G, Mazzucchi A. Analysis of higher nervous functions in migraine and cluster headache. Funct Neurol 1987; 2:69-77. [PMID: 3678942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Three groups of patients, long-time sufferers from classic migraine, common migraine, and cluster headache respectively, and three control groups, age- education- and sex-matched, underwent a set of neuropsychological tests and tachistoscope tasks in order to evaluate cognitive functions and interhemispheric balance. Migraineurs and cluster headache patients were selected on the basis of the constant (90%) unilaterality of both pain and focal neurological deficits. No significant differences emerged between patients and controls in any of the neuropsychological and tachistoscopic tasks administered, thus indicating that between attacks of migraine as well as of cluster headache no evidence of cortical dysfunction is detectable.
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Affiliation(s)
- E Sinforiani
- Department of Neurology, C. Mondino Foundation, University of Pavia, Italy
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36
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Mazzucchi A, Parma M. Changes in interhemispheric functional balance in epileptic and migraine patients. Funct Neurol 1986; 1:375-8. [PMID: 3609868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
In relation to the general problem of neuropsychological conditions in epileptic and migraine patients, the literature is reviewed and new data are presented emphasizing the specific heuristic value of methods investigating interhemispheric functional balance. Available data indicate that: a) in epileptic monohemispheric non-lesional patients an interhemispheric functional change in favour of the epileptic hemisphere is detectable, more manifest when the left hemisphere is involved; b) in migraine patients interhemispheric functional changes are detectable only during the paroxysmal phase, more manifest when the left hemisphere is involved.
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37
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Zavaroni G, Faglia L, Zinelli P, Mazzucchi A. [Changes in "same-different" strategy in left or right brain damage]. Boll Soc Ital Biol Sper 1986; 62:1157-63. [PMID: 3801199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Terzano MG, Parrino L, Mazzucchi A, Moretti G. Confusional states with periodic lateralized epileptiform discharges (PLEDs): a peculiar epileptic syndrome in the elderly. Epilepsia 1986; 27:446-57. [PMID: 3720705 DOI: 10.1111/j.1528-1157.1986.tb03566.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The histories of seven patients over the age of 60 years are reported. They all suffered from recurrent and prolonged episodes of confusional state associated with psychic and neurologic manifestations. All episodes were accompanied by the occurrence of periodic lateralized epileptiform discharges (PLEDs) on the EEG, which became normal when the ictal episodes subsided either spontaneously or after administration of diazepam i.v. Although PLEDs may correspond to severe hemispheric lesions, serial computed tomography (CT) scan and laboratory investigations detected significant abnormalities in only one case, that of a patient with a progressive dementing outcome. In the other six patients, follow-up neuropsychological controls indicated moderate impairment of higher cortical functions according to the hemisphere involved by PLEDs. Administration of carbamazepine (CBZ) proved rather effective in preventing the recurrence of the ictal episodes. For its clinical, EEG, and prognostic features, this condition may represent a peculiar nonconvulsive status epilepticus in the elderly.
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Abstract
Sixty subjects with uncomplicated essential hypertension and 60 matched normal subjects were submitted to neuropsychological tests in order to establish whether some impairment of cognitive functions can be evidenced even in those hypertensive subjects that are in this respect asymptomatic on standard examination and interview. The hypertensive subjects obtained significantly poorer results than normotensive subjects on memory, visuo-motor and performance tests. In the control group, the classic negative correlation pattern between age and scores was observed, while in the patient group this correlation could be confirmed only in a few tests. Subgrouping of patients according to hypertension duration and treatment showed that the impairment of cognitive functions manifested itself very early and did not tend to progress within 6-10 years of hypertension duration.
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Mazzucchi A, Visintini D, Magnani G, Cattelani R, Parma M. Hemispheric prevalence changes in partial epileptic patients on perceptual and attentional tasks. Epilepsia 1985; 26:379-90. [PMID: 3930231 DOI: 10.1111/j.1528-1157.1985.tb05668.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
In relation to the general issue of the long-term effects of epileptic activity on the higher nervous functions, monohemispheric epileptic patients--divided into "lesional" [i.e., with computed tomography (CT) scan-visible lesions] and "nonlesional" (i.e., with CT scan-nonvisible lesions)--were submitted to dichotic verbal and tonal tasks, dichoptic verbal and spatial tasks, and a visual tachistoscopic attentional task. The aim was to investigate whether the typical patterns of hemispheric prevalence, which were observed in normal subjects by using these tests, undergo significant changes in epileptic patients. The findings versus normal subjects seem to demonstrate that (a) in lesional epileptic patients, the prevalence of the hemisphere without macroscopic lesions is a constant rule, whether or not this hemisphere is prevalent in normal subjects; (b) in nonlesional epileptic patients, the patterns are the following: when the epileptic hemisphere is the one that is prevalent in normal subjects, its prevalence is enhanced, whichever the hemisphere; when the epileptic hemisphere is not the hemisphere prevalent in normal subjects, the left one attracts and maintains prevalence, whereas the right one reduces and variously interferes with contralateral prevalence. It is concluded that, with respect to the functions tested, the nature of the epileptic foci seems to influence markedly the interhemispheric prevalence pattern.
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41
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Mazzucchi A, Parma M, Umilta' C, Visintini D, Zavaroni G. Visual attention in patients with unilateral lesional or non-lesional epileptic focus. Boll Soc Ital Biol Sper 1985; 61:1051-7. [PMID: 3935139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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42
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Abstract
A case of unilateral visual agnosia for all types of stimuli limited to the left visual hemifield and associated with a right occipital temporal vascular lesion is reported. Questions raised by this case of hemiagnosia as compared to previous ones are discussed.
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43
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Magnani G, Mazzucchi A, Parma M. Interhemispheric differences in same versus different judgments upon presentation of complex visual stimuli. Neuropsychologia 1984; 22:527-30. [PMID: 6483181 DOI: 10.1016/0028-3932(84)90049-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
An experiment is reported which was aimed at investigating interhemispheric differences upon tachistoscopic presentation of Same vs Different stimuli, i.e. pairs of 16-side Vanderplas and Garvin figures selected for their complexity, unfamiliarity and lack of verbalization. The right hemisphere was found to be faster and more accurate in Same judgements and the left hemisphere in Different judgements. These findings seem to further confirm the assumption that the right hemisphere would mostly use a holistic strategy and the left hemisphere an analytic strategy.
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Mutti A, Mazzucchi A, Rustichelli P, Frigeri G, Arfini G, Franchini I. Exposure-effect and exposure-response relationships between occupational exposure to styrene and neuropsychological functions. Am J Ind Med 1984; 5:275-86. [PMID: 6720691 DOI: 10.1002/ajim.4700050404] [Citation(s) in RCA: 76] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
A neuropsychological test battery was administered to 50 workers exposed to styrene and to 50 sex-, intelligence-, and age-matched controls. The main styrene metabolites, ie, mandelic acid (MA) and phenylglyoxylic acid (PGA), were measured as exposure indices in the urine collected on Saturday mornings, just before neuropsychological testing. Exposure-response and exposure-effect relationships were found between the intensity of the exposure (as reflected by the sum of MA and PGA) and the scores of the neuropsychological tests. Verbal learning skills were significantly impaired in workers with a sum of MA and PGA higher than 150 mmole/mole creatinine, corresponding to styrene airborne concentrations higher than 25 ppm (mean daily exposure). Logical memory and visuo-constructive abilities were shown to be significantly affected in workers with MA and PGA higher than 300 mmole/mole creatinine, corresponding to exposure levels of more than 50 ppm of styrene in air.
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45
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Mazzucchi A, Cattelani R, Michelotti MG, Magnani G, Passoni M, Paini PP, Parma M. [Neuropsychologic and behavioral sequelae of cranial injuries: remarks on classification, diagnosis and correlation with injury variables]. Riv Neurol 1984; 54:1-51. [PMID: 6718958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The psychological and behavioural impairment following head injury has been investigated in order to throw light on and assess the related epidemiological aspects, methodological approaches, clinical manifestations, and the correlations between the sequelae and the variables of head trauma, i.e. degree of severity of trauma, age of patients, presence or absence of fractures and haematoma. This study was conducted on 117 head- injured patients and 43 matched "control" subjects. The findings point out the following: a) Even the medical staff is often largely misinformed about this type of sequelae. The methods used for assessment should therefore be further developed and a more systematic evaluation of the higher functions following head injury appears to be necessary. b) The syndromes observed are mostly of a composite and diffuse type. It is therefore difficult to classify them according to strict criteria; indeed, it appears that the only possible approach is to define large groups of head- injured patients based on clinical description, which are partly borne out and partly described ex novo in the present series. c) As regards the correlations between the variables of the injury and the resulting neuropsychological impairment, the age factor should be distinguished from the severity of injury. If it is true that the older patients, the greater the impairment, such a direct correlation no longer exists when severity of the injury is considered. Indeed, the latter does not appear to be a significant differential factor in determining the degree of impairment. Similarly, whether the injury is an "open" or "closed" one, or the presence of haematoma do not appear to be differential factors, either.
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Abstract
A case review of prosopagnosia was carried out and male-female incidence of the disorder compared to relative male-female incidence of cerebro-vascular disease in general. Prosopagnosia was found to occur significantly more frequently in males than in females. Possible implications of this finding vis-à-vis male-female differences in cerebral organization are discussed and topics for further investigation are suggested.
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Mutti A, Mazzucchi A, Rustichelli P, Arfini G, Franchini I. Interactive effects of age and exposure to styrene on the higher nervous functions. Toxicol Lett 1983. [DOI: 10.1016/0378-4274(83)90368-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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48
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Abstract
Two patients with agrammatic speech and unimpaired comprehension are presented and contrasted. Case 1 had an infarction involving precentral gyrus, subjacent white matter, and posterior and superior aspects of the insula, largely sparing Broca's area. His speech was slow and dysarthric, consisting of short disconnected phrases with some omission of lexical verbs. Case 2 had an unusual transient aphasia of acute onset without hemiplegia; speech rate, articulation, and sentence length and complexity appeared normal. Both patients tended to omit function words and finite verb inflections, but Case 2 did so much more than did Case 1. Neither patient showed impairment in any other area of language performance. Tentatively, Case 2 is described as being more morphologically impaired but less syntactically impaired than Case 1, while neither has damage to a central language processor.
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Mazzucchi A. Mazzucchi replies. Journal of Neurology, Neurosurgery & Psychiatry 1983. [DOI: 10.1136/jnnp.46.5.464-b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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50
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Abstract
Two experiments were conducted in which monaural clicks were presented to the right or left ear preceded by binaural verbal (Experiment 1) and musical (Experiment 2) warnings. After the "neutral" warnings, the clicks could be presented to the right or left ear equally often (50%); after the warnings which directed the attention to the left or right ear, the clicks could be presented to either the "expected" (67%) or to the "unexpected" (33%) ear. In Experiment 1 there was a cost effect for the "unexpected" ear and reaction times were significantly faster when the clicks were presented to the right ear. In Experiment 2, the musical warnings brought about a cost effect while no significant ear advantage was observed.
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